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Transcutaneous Electrical Stimulation: Definition and the Mechanisms of Action

A newscaster reporting about TENS as a new pain relief

Many people know transcutaneous electrical stimulation as Transcutaneous Electrical Nerve Stimulation or TENS. It is a fast-acting and natural method of pain relief. This technique uses an electronic device with sets of electrode patches. The unit sends mild electrical signals to trigger the release of endorphins. Moreover, these electric currents help block the transmission of pain messages to the brain. Then, these analgesic mechanisms help relieve various types of pain in adults.

Usually, individuals experiencing a painful condition go to a pain clinic or hospital. Afterwards, healthcare professionals will prescribe or recommend traditional pain management methods. These include physical therapy, medications, or surgery. However, for those looking for a non-invasive and drug-free option, TENS may be the answer. Nevertheless, knowing its components is essential. Hence, the article will present what it is, its mechanisms of action, and the condition types it can help with.

What is Transcutaneous Electrical Stimulation?

Transcutaneous electrical stimulation is a natural treatment method. It utilises a portable electrical device to emit low-voltage electrical currents. Then, this method of pain relief uses adhesive electrode patches to send the electrical pulses to the pain area. People can choose from various pad shapes and sizes that will suit the body part they are targeting.

In addition, electrical nerve stimulation machines come in different types. The traditional one is the handheld or wired model. It typically requires the user to hold onto it while undergoing a treatment session. Meanwhile, the more modern version is the wireless unit. Individuals can wear this type discreetly under clothing. Thus, they experience more freedom of movement during therapy.

Electric nerve stimulation is generally safe for all. Nevertheless, it is crucial to consult a medical provider beforehand. They can tailor the settings and electrode placements according to the specific needs and type of pain the patient has. Moreover, people should note that TENS is not suitable for everyone. Therefore, receiving advice from professionals is vital.

Brief History

The following is the brief timeline of the evolution of electrical nerve stimulation:

  • Early use in Ancient Rome: People used electric fish for pain relief. They apply it to the body to alleviate aches.
  • 18th and 19th centuries: Experimentation with electricity for medical purposes increased during this time, leading to the development of early forms of electrical stimulation.
  • 20th century: Reasearchers developed TENS as a non-invasive form of pain reliever. Individuals placed electrodes on the skin to deliver electrical pulses to nerve fibres.
  • Modern advancements: The TENS technology continues to evolve, with portable and programmable devices now widely available for clinical and home use.

A woman pressing a button of the TENS machine on the back of her hand

Mechanisms of Action Behind Transcutaneous Electrical Stimulation

The mechanism of action behind transcutaneous electrical stimulation involves delivering gentle electrical currents. It works through electrode pads users place on the skin. Afterwards, people can select the settings they prefer. They can choose higher frequencies at 50 Hz or more to activate the pain-gating method. This option modulates the transmission of pain signals in the central nervous system.

On the other hand, individuals can opt for lower frequencies at less than 10 Hz. This mechanism boosts the production of natural painkillers, which are endorphins. As a result, this further contributes to its pain-relieving effects. Moreover, this setting can play a role in regulating mood and emotions, leading to an overall sense of well-being.

Furthermore, electric nerve stimulation has an anti-inflammatory effect. This means it can help reduce swelling and inflammation in the body. The electrical pulses stimulate the release of anti-inflammatory substances, helping to alleviate pain and promote healing. Using all mechanisms makes TENS a valuable and versatile tool for managing various acute and chronic pain conditions.

Frequencies and Intensities

Frequencies of electrical nerve stimulation refers to the number of electrical pulses the machine delivers per second, measured in Hertz (Hz). Low-level frequencies are suitable for managing chronic pain conditions. The reason is that the effects last longer. Meanwhile, users with acute pain conditions can find more relief in high-level frequencies since these are fast-acting.

Intensities of electrical stimulation for pain relief refers to the strength of the electrical current the device sends to the skin. It is typically measured in milliamperes (mA). Individuals can adjust this to stimulate sensory nerves for pain reliever or motor nerves for muscle contraction.

A woman using a TENS machine on her lower back

Types of Pain Conditions Treated with Transcutaneous Electrical Stimulation

Transcutaneous electrical stimulation is versatile because it can treat various types of pain in adults. Firstly, it helps chronic pain conditions, referring to pain that lasts for more than three months. Some examples are cancer pain, arthritis, back pain, and fibromyalgia. As a note, people should choose electrode patches appropriate to the size and location of their pain for optimal results.

Secondly, TENS can manage acute pain conditions, which are sudden and short-term pain. These include labour pain, menstrual cramps, postoperative pain, and sports injuries. Thirdly, this form of pain relief can aid musculoskeletal pain conditions. These refer to pain affecting body parts like muscles, bones, ligaments, and tendons. Foot, shoulder, elbow, and neck pain are some examples.

Lastly, electric nerve stimulation can help with neuropathic pain conditions. These occur when damage or malfunction to the nerves causes discomfort. These include diabetic neuropathy, postherpetic neuralgia, stump pain, and sciatica. With the ability to adjust the settings of TENS, an individual suffering from one or more painful conditions can tailor it to suit their specific needs.

Is It Safe?

Health professionals and researchers generally consider TENS safe as long as people use it correctly and under the guidance of a medical provider. The low-voltage electrical currents from the machine are not known to cause any significant harm to the body when users apply TENS properly. However, those with certain medical conditions, such as pacemakers or heart conditions, must be extra cautious.

Like any medical treatment, TENS has potential risks. For instance, improper application can lead to skin irritation, burns, or discomfort. Also, they should not attach the adhesives to areas with broken skin. Thus, receiving proper education and training on its usage is vital.


Transcutaneous electrical stimulation, more popularly known as TENS, is a natural form of pain relief. It utilises a battery-operated device and electrode pads to send low-voltage electrical currents to the skin. The mechanisms of action involve stimulating the nerves to disrupt pain signals and promote the release of endorphins. Additionally, TENS can help reduce swelling. Users can choose from high or low frequencies depending on their conditions to activate these methods.

TENS is commonly used to manage a wide range of pain conditions. These include chronic, acute, musculoskeletal, and neuropathic pain like chronic back pain, fibromyalgia, postoperative pain, period cramps, neck pain, and sciatica. It is a safe and effective alternative or complement to traditional pain management strategies, with minimal side effects. Nevertheless, cautiousness is necessary to prevent potential risks such as skin irritation or burns. Users must consult a doctor beforehand.

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